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Compliance up 69% with Opioid Risk Management program

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Progress in the fight against opioid misuse and abuse

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So as most people are well aware, we're in the midst of the worst healthcare crises our nation has ever faced, with our current opiate epidemic. This is a crisis that we at OptumRx take very seriously. It's one of our highest clinical priorities as an organization, and as such, we've developed what I believe to be one of the most comprehensive, multidimensional programs in the industry. It focuses, first and foremost, on prevention and education, educating providers, educating patients on the appropriate use of opiate drugs. Two of the biggest components that are driving the greatest success are minimizing early exposure, that's patients who are naive to opiate therapy, being prescribed one of these drugs for the first time. CDC guidelines call for the lowest dose, and the shortest duration of therapy possible. We're enforcing that through utilization management edits that we've deployed within our systems today. Beyond that, it's about identifying and managing high-risk patients, and then supporting patients who are afflicted with opiate use disorder, making sure they have access to the right therapies, and that they're supported throughout the course of that lifelong battle that they will have to manage that condition and stay in recovery. We are now at about 95% compliance with CDC guidelines for first-fill opiate utilizers, so keeping them below seven days, in terms of the duration of therapy, but also taking it one step further, and also reducing the amount of drug that that patient could consume per day, keeping that to 50 morphine milligram equivalence per day or less, in line with CDC guidelines. For the chronic utilizers, we now have a 96% compliance rate, in terms of keeping their doses below 90 morphine milligram equivalence per day, in line with CDC guidelines. And lastly, and probably most important, we were also able to demonstrate a 50% relative risk reduction in the percentage of people who transitioned from that first-fill prescription to chronic use of 30 days or longer. That, to me, is going to be the most impactful way that we're gonna reduce the prevalence of opiate use disorder in the long run, by keeping fewer patients from moving on to that chronic use state.

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Hear from OptumRx Chief Pharmacy Officer, David Calabrese, on what makes this solution so effective and get the latest results on how the program is performing in the infographic.

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Outcomes of an opioid action plan

Results are in on how well the Opioid Risk Management program is helping to curb opioid misuse and abuse. 

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